Human T-cell lymphotropic virus-III (HTLV-III) seropositivity and related disease among 71 consecutive patients in whom tuberculosis was diagnosed. A prospective study

The incidence of tuberculosis has recently risen in Southeast Florida. In order to determine the number and proportion of tuberculosis cases and the characteristics of tuberculosis that might be related to human T-cell lymphotrophic virus-III (HTLV-III) infection, all patients seen by the Dade County Florida Public Health Department-Tuberculosis Clinic during a 6-month period were medically evaluated and screened for HTLV-III antibody by an enzyme-linked immunosorbent assay. Of 71 consecutive patients confirmed to have tuberculosis (70 by culture) during the study period, 22 (31%) were seropositive and 49 (69%) were seronegative for HTLV-III antibody. The seropositive group had a significantly higher proportion of patients who were black, Haitian, and within the age group of 25 to 44 yr. The seropositive group also had a significantly higher rate of mild-to-moderate serum aspartate transaminase elevations (less than or equal to 5 times normal), tuberculin skin test false negativity, extrapulmonary tuberculosis (especially lymphatic), and pulmonary tuberculosis with an atypical radiographic picture. The seropositive group had a significantly lower proportion of patients with sputum cultures positive for M. tuberculosis. There was no significant difference between the groups with respect to the proportion of patients with positive sputum smears when sputum cultures were positive, serious antituberculosis drug reactions (requiring discontinuation of therapy), or percent of home contacts who were tuberculin skin tested and found to be positive. At the time of the diagnosis of tuberculosis, only 6 (27%) of the seropositive patients with tuberculosis had clinical evidence of AIDS or AIDS-related complex (unexplained thrush).(ABSTRACT TRUNCATED AT 250 WORDS)     

Modulation of regulatory T-cell activity in combination with interleukin-12 increases hepatic tolerogenicity in woodchucks with chronic hepatitis B

Regulatory T cells (Treg) play a critical role in the modulation of immune responses to viral antigens in chronic viral hepatitis. Woodchucks (Marmota monax) infected with the woodchuck hepatitis virus (WHV) represent the best animal model for chronic hepatitis B virus (HBV) infection. Examination of intrahepatic and peripheral Treg in uninfected and WHV chronically infected woodchucks showed a significant increase of intrahepatic Treg numbers in chronically infected animals, whereas no differences were found in peripheral blood. In agreement with these data, higher expression levels of Forkhead box P3 (Foxp3), interleukin (IL)-10, transforming growth factor beta (TGF-β) were detected in the liver of chronic WHV carriers in comparison to uninfected animals. Furthermore, treatment of WHV-infected animals with an adenovirus encoding IL-12 failed to reduce viral load, a finding that was associated with lymphocyte unresponsiveness to IL-12 stimulation in vitro. We observed that TGF-β and Treg play a major role in the lack of lymphocyte response to IL-12 stimulation, as TGF-β inhibition and Treg depletion allowed recovery of T-cell responsiveness to this cytokine. Based on these results, woodchucks were treated with IL-12 in combination with a TGF-β inhibitory peptide or Treg depletion. However, no antiviral effect was achieved and, instead, an enhancement of the intrahepatic tolerogenic environment was observed. CONCLUSION: Our data show that TGF-β inhibition or Treg depletion had no added benefit over IL-12 therapy in chronic WHV infection. IL-12 immunostimulation induces a strong immunosuppressive reaction in the liver of chronic WHV carriers that counteracts the antiviral effect of the treatment.     

Aging increases mitochondrial DNA damage and oxidative stress in liver of rhesus monkeys

While the mechanisms of cellular aging remain controversial, a leading hypothesis is that mitochondrial oxidative stress and mitochondrial dysfunction play a critical role in this process. Here, we provide data in aging rhesus macaques supporting the hypothesis that increased oxidative stress is a major characteristic of aging and may be responsible for the age-associated increase in mitochondrial dysfunction. We measured mitochondrial DNA (mtDNA) damage by quantitative PCR in liver and peripheral blood mononuclear cells of young, middle age, and old monkeys and show that older monkeys have increases in the number of mtDNA lesions. There was a direct correlation between the amount of mtDNA lesions and age, supporting the role of mtDNA damage in the process of aging. Liver from older monkeys showed significant increases in lipid peroxidation, protein carbonylations and reduced antioxidant enzyme activity. Similarly, peripheral blood mononuclear cells from the middle age group showed increased levels in carbonylated proteins, indicative of high levels of oxidative stress. Together, these results suggest that the aging process is associated with defective mitochondria, where increased production of reactive oxygen species results in extensive damage at the mtDNA and protein levels. This study provides valuable data based on the rhesus macaque model further validating age-related mitochondrial functional decline with increasing age and suggesting that mtDNA damage might be a good biomarker of aging.     

Do Implant Length and Width Matter for Short Dental Implants (<10 mm)? A Meta‐Analysis of Prospective Studies

Background: This meta‐analysis of prospective clinical trials was conducted to determine the effects of dental implant length and width on implant survival rate of short (<10 mm) implants. Methods: An electronic search of the PubMed database for relevant studies published in English from November 1998 to March 2012 was performed. Selected studies were randomized clinical trials, human clinical trials, or prospective trials with a clear aim of investigating the success or survival rate of short (<10 mm) implants. Results: Eight studies fulfilled the inclusion criteria and were subsequently analyzed. A total of 525 short (<10 mm) dental implants were analyzed, of which 253 were 3.5 mm in diameter (48.19%), 151 were 4.0 mm (28.76%), 90 were 4.1 mm (17.14%), 21 were 4.8 mm (4%), and 10 were 5.1 mm (1.9%). All implants included in this meta‐analysis had a follow‐up period of 12 to 72 months. The included studies reported on the survival rate and diameter of the implants. Six of the studies used “short implants” (7 to 9 mm), and the remaining were classified as “extra‐short implants” (≤6 mm). Five‐year estimated failure rates were 1.61% and 2.92%, respectively, for extra‐short and short implants (z = ?3.49, P <0.001, 95% confidence interval = 0.51% to 4.10%). Furthermore, it was found that the wider the implant, the higher the failure rate (estimated failure rate = 2.36%, 95% confidence interval = 1.07% to 5.23%). Conclusions: Neither implant length nor width seemed to significantly affect the survival rate of short implants (<10 mm). Nonetheless, further well‐designed randomized clinical trials are needed to confirm these findings.     

Palatonasal Recess on Medial Wall of the Maxillary Sinus and Clinical Implications for Sinus Augmentation via Lateral Window Approach

Background: Anatomic variations of the maxillary sinus determine the degree of difficulty in performing sinus augmentation. Whereas some variations, e.g., the septum and morphology of the sinus, have been extensively studied, the structure of the medial wall has never been investigated. The aims of this study are to measure the location and angulation of the palatonasal recess (PNR) on the medial wall and identify risk sites that are related to the shape of the PNR. Methods: Cone‐beam computed tomography (CBCT) scans were screened from the University of Michigan School of Dentistry database. Edentulous sites with <10 mm between the floor of the maxillary sinus and the alveolar crest were selected. The residual ridge height (RH), the distance between the PNR and the alveolar crest, and the angulation of the PNR were measured on the selected sagittal planes. The percentage of sites (risk sites) with recesses that were <90°and <15 mm from the alveolar crest was calculated. The PNR location and angulation were compared among premolar and molar edentulous sites. Results: Two hundred seventy‐four sites were studied. The mean ± SE PNR location was 14.2 ± 2.8 mm, 13.1 ± 2.2 mm, and 12.5 ± 2.5 mm for the second premolar, first molar, and second molar sites, respectively, with significant differences between the second premolar and second molar sites. The mean PNR angulation was 109.8° ± 25.3°, 121.6° ± 22.1°, and 144.9° ± 23.1° in the corresponding sites, with significant differences among the site groups. The respective percentages of risk sites were 15%, 8.2%, and 2.4% in the second premolar, first molar, and second molar sites. Conclusions: Maxillary sinuses with acute‐angled PNRs might present a challenge for performing sinus augmentation. Therefore, this anatomic structure should be carefully evaluated.     

Linfadenectomía inguinal vídeo endoscópica: resultados quirúrgicos y oncológicos

IntroductionWe evaluated the reproducibility of video endoscopic inguinal lymphadenectomy (VEIL) and we report our initial experience in the treatment of penile cancer with palpable inguinal lymph nodes.Material and methodsFrom July 2006 to November 2010 were conducted 33 VEIL in 20 patients as complementary treatment for penile cancer in two referral hospitals in Latin America. We analyzed the epidemiological and clinical characteristics of patients and surgical and oncologic outcomes.ResultsFifty-five percent of the patients included were clinical stage N0 and 45% were N +. Thirteen patients underwent bilateral VEIL and the remaining seven underwent VEIL unilateral and conventional open surgery in the contralateral limb. The average operative time for VEIL was 119 minutes and mean resected lymph nodes was 8 per lymphadenectomy. The overall complication rate was 33.2%. No patient had skin necrosis. The lymphatic complication rate was 27.2%. Of the 6 cases in which the saphenous vein was preserved (18.2%) there were no lymphatic complications (P = ,2). The overall survival rate was 80% and cancer-specific survival was 90%. Mean follow-up was 20 months.ConclusionsVEIL in the adjunctive treatment of penile cancer is safe, reproducible and may be an alternative to conventional lymphadenectomy. Patients with palpable lymphadenopathy also may benefit from this technique. Oncological results seem to be adequate however require longer follow-up to be confirmed.